#69 - How are Mast Cell Diseases Treated?

Where do you begin with mast cell disease treatment when there is such variation among patients?

Dr. Milner is back with us to discuss the difficulties in treating mast cell activation syndrome and mastocytosis. We will discuss the different approaches to treating mast cell disease and the medications used for mastocytosis treatment. Since no single treatment plan works for everyone, we will explore multiple strategies that can be helpful in managing this condition.

A note: when you hear MCAS mentioned, it stands for Mast Cell Activation Syndrome.

What we cover in our episode about treating mast cell diseases:

• What are the steps taken to treat mast cell diseases?

• Histamine blockers: antihistamines for mast cell disease and H2 blockers

• Mast cell stabilizers: Cromolyn and Ketotifen

• Xolair

• Other medications that have been used but not recommended: aspirin, steroids, Singulair

• Epinephrine and anaphylaxis

• Tyrosine kinase inhibitors (TKI) for Mastocytosis: Avapritinib, Midostaurin

• Safety concerns and side effects of Tyrosine kinase inhibitors

• Multidisciplinary approach to managing mast cell disease

About our guest - Dr. Josh Milner

Joshua Milner, MD, is a renowned leader in discovering and understanding genetic diseases leading to allergic symptoms, including Hereditary Alpha Tryptasemia Syndrome, PLAID, PGM3 deficiency, ERBIN mutation, and others. With a background in biology from MIT and an MD with distinction in immunology from Albert Einstein College of Medicine, Dr. Milner has extensive experience in pediatrics and allergy and immunology, serving as chief of the Laboratory of Allergic Diseases at NIAID.

His vision is to leverage genetic variation to improve diagnosis and care for patients with allergic diseases through comprehensive genetic sequencing and functional studies, aiming for personalized medicine and interdisciplinary collaboration in pediatric allergy, immunology, and rheumatology.

More about Dr. Milner:

• https://www.pediatrics.columbia.edu/profile/joshua-milner-md

More resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

• FDA Approves AYVAKIT® (avapritinib) as the First and Only Treatment for Indolent Systemic Mastocytosis: https://ir.blueprintmedicines.com/news-releases/news-release-details/fda-approves-ayvakitr-avapritinib-first-and-only-treatment